Tag: nhs

A Mental Health task force set up by Nick Clegg has decided to subject people on benefits to mental health treatment at the Job Centre.

Out of all the possible environments for mental health treatment, the Job Centre could the worst.

The treatment will take the form of talking therapy and computer-based Cognitive Behavioural Therapy. A posting on the governments’s Contracts Finder website reveals that the DWP intend to spend £21 million on the online CBT. It is not clear how much they intend to spend on human therapists, where they think they can get them, or whether they will actually have training and experience to do the job.

There are so many problems with this scheme that it is hard to know where to start. The biggest problem I can see is that there can be no meaningful consent to treatment in the context of the Job Centre. Where once the Job Centre was there to help people to find a job, these days it is more known for ruthless sanctions and cutting off benefits for whatever trivial excuse they can come up with. If Job Centre staff tell someone that they need mental health treatment it will be backed up with words such as “your benefits may be affected if you do not attend” which is a barely-veiled threat that they apply to most “voluntary” tasks that they inflict on people.

The regime of sanctions and workfare means that the Job Centre is a direct cause of much mental illness among people on benefits. I cannot see anyone wanting to reveal this to any therapist in the Job Centre even if absolute confidentiallity is promised. There is too much danger of it leaking to vindictive staff who are eager to hit their targets for sanctions.

Computer-based CBT could be even worse. CBT does not work for everyone and there is a chance that staff will use failure to get better as an indication that someone is not trying, and an excuse to cut their benefits. CBT often makes people worse before they get better and it is not something that should be done in a public place where there is little chance of privacy. It could leave people in a raw emotional state and vulnerable while out in public, or the setting may prevent people from engaging at all. Indeed, the suspicion will be that Job Centre staff will monitor progress just like they monitor the Universal Job Match system.Whether true or not, that will be a barrier to a lot of people.

This whole scheme seems to have been set up with the primary aim not of improving mental health, but of getting people in to a job. There is no indication of how the DWP will treat people whose mental health does not improve enough to get a job, or even get worse. Clegg’s mental health task force seems to have no clue about the reality of unemployment, poverty or illness. Had they asked anyone in this situation they would have been told that this plan will be damaging, not helpful.

If there is money available – and seemingly, there is at least £57 million available – why on earth isn’t it being spent within the NHS to undo some of the savage cuts that have taken place? Lots of people including myself have been desperate to get proper talking therapy from the NHS for years but unable to do so. Tories and LibDems seem desperate to force unsuitable treatment without consent on people on benefits instead of properly funding NHS services. This scheme is a useless bandage on the gaping wound inflicted by this government and it will do more damage than it helps repair.

Today the Health and Social Care Act comes into force. One of the things it does is split the NHS up and put the parts out to tender to the lowest bidder. This video is an interview with Dr Lucy Reynolds who is a research fellow at London School of Hygiene and Tropical Medicine and she explains exactly how this works and what it means for the NHS.

Lucy Reynolds: We’re not going to have a big bang privatisation for the NHS. We’re going to have a very quiet one.

What has happened is that all of the rules that control health financing have been gradually changed since the New Labour times. Overall, we now have the NHS reorganised in such a way that it can be relaunched as a mixed market, so not just the public health sector service, but also a healthcare industry. The rules are structured in such a way that there will be a gradual transition between those two groups. The public sector will shrink away, and the private sector will grow.

But because there will never be an announcement in parliament that the NHS is privatised, and because the private providers will be allowed to use the NHS logo for anything that they are getting NHS funding for, it is very likely that the general public will not be aware that the private sector has in fact come in and taken over whatever bits of the NHS it finds profitable until probably service provision gets fairly bad.

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it sounds like a good idea to have diversity and options and these kinds of things, and that would be fine if it weren’t for the fact that the rules of the market are thoroughly stacked. We know for certain that organising [healthcare] as a public sector service is the cheapest and most effective way of providing healthcare. And that is broadly because the market model does not fit healthcare. The market model includes assumptions that both parties are in possession of all information about the subject of the transaction. In markets where the consumer has to rely upon the supplier for guidance, what you get isn’t a market that clears down to a minimum price and is efficient. What you get is soaraway inflation and abuse within that market.

—–

If you pay doctors only when they do work, then they over-treat people. If you make sure that medical facilities have no way of making any money other than by selling things, then they become salesmen, not advisers and advocates for the public. And actually in the world we have one of the very best public services, and compared to other developed countries it’s also one of the most cost effective

—–

The health service is being restructured on to an insurance compatible footing, and the CCGs are technically state-owned insurance schemes. So they are going to be taking on around 80% of the NHS budget and they are going to be parcelling it out to providers. They have been told that they are going to have a lot of autonomy in that and that they will be able to represent the interests of their patients in the matter.

That bit doesn’t appear to be able to be delivered when we have these regulations in place because what the regulations say is that commissioners will put out contracts according to competition law, and they will decide according to competition law. If anybody that didn’t get the contract feels that they don’t like the decision and that it could be faulted on failure to comply with competition law, they are permitted to complain to the sector regulator, Monitor, which is required to enforce competition law. So once everything gets put through the market, the CCGs won’t actually have any autonomy in the matter.

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It’s not suddenly going to turn into a privatised service on 1 April. What happens on 1 April is a bunch of legal and operational changes that affect the way that the NHS functions internally. In general this reform is a health financing reform. So we’re finishing the transition away from the original form of funding of the NHS and moving into a market system which is going to be full-on market.

It should be obvious that buying one is not really an option for most people living on sickness and disability benefits. Many people who need a high end power wheelchair do lease one from the Motability scheme however that option is not available to those who already use their DLA to lease a car through the scheme, or who do not receive DLA at all. In some circumstances a charity might be willing to foot some or all of the bill for a power wheelchair. Specialist charities for certain diseases or impairments might do this although in practice most do not have this option either. In my case there is a charity that helps people in the area that I live in who might be able to pay for part of the cost of a power wheelchair for me but since charity funds must be carefully looked after they require me to need a wheelchair but be unable to get one from the NHS before they will help. That leads me to the main option, to ask for a wheelchair from the NHS.

Soon after my power wheelchair broke an occupational therapist referred me to Worcestershire Wheelchair Services and I was told that I would get an assessment but that I would have to wait a long time. In the meantime I bought a manual wheelchair using my credit card. I have a bankruptcy in my past because of my illness so that credit is at an interest rate of 34% APR.

I knew when I was referred for a wheelchair assessment that I would not qualify for a power wheelchair because I only need a wheelchair when out of the house but that was OK because once I had an assessment I could turn to my local charity. As I understood then from other doctors and therapists I should qualify for a manual wheelchair, although probably one with small wheels that required an attendant to push it because self-propelling a wheelchair soon hurts my arms as much as walking hurts my legs. (This is why I purchased a self-propel chair, since I would like to be able to turn myself around even if I mostly have someone pushing.)

Then, today, I received this letter from Wheelchair Services. (Click to enlarge.)

The letter informed me that I would not receive any wheelchair from the NHS because in Worcestershire they are

“Currently only able to supply wheelchairs to people who meet higher level needs i.e. to those clients who have a permanent mobility problem, who are unable to walk and who require a wheelchair within their own home.”

So, because I can walk or stagger around at home, I will not receive any kind of wheelchair to help outside where I cannot walk more than a few metres or stand up for more than a few seconds – not even a manual wheelchair. They won’t even visit to assess me. There are also many people who need a power wheelchair but are unable to get one from the NHS because they, like me can walk to some extent around their own home. In a lot of these cases they would use a wheelchair inside if only they could fit one in their home, but because they cannot they too are denied any help from wheelchair services. I know of several people who are currently trying to raise funds through donations to purchase their own power wheelchair because of this.

I’m not too worried about this in my own case because I have the manual wheelchair that I bought, and I have my wife to push it much of the time, and I still hope to get help from a local charity. I am far more worried about all the other people who haven’t been so fortunate and have no chance to buy a wheelchair, no charity help, no car and no one to offer lifts. I struggle to understand the justification for the NHS in Worcestershire not giving a wheelchair to people who need one but only when outside. If applied nationally, this policy would trap tens or hundreds of thousands of people in their own homes, unable to go out to medical appointments, to buy food or to visit family and friends. I don’t know how long this policy has been in place in Worcestershire but I hope that it is the only area doing this.

Worcestershire Wheelchair Service informed me that their qualifying criteria have been this way for a number of years due to low funding. Worcestershire is not looking like a good place for a chronically sick or disabled person to live right now; Worcestershire council are planning to remove funding for care at home for a large number of people and send them to live in care homes instead. This is a huge backwards step, a removal of freedom for a lot of people and reverts to the old method of locking those with disabilities away from society. This policy on wheelchairs will ensure that more people are trapped at home and so require care from the local authority, which in turn may put them into a care home.

Are we as a country really so short of money that this is the route we want to take?

A very distressing incident happened at Addenbrookes hospital in Cambridge today, in Health Minister Andrew Lansley’s own constituency. After major surgery Sue Marsh was given a drug that she is allergic to which caused her even more pain, and stubborn nurses refused to give her any other pain relief.

Sue was left in agony after her operation to remove a large section of her bowel when she was given Fentanyl while under anaesthetic. Sue is allergic to Fentanyl and far from reducing pain it actively increases it. (She has previously written about her horrific 1997 experience with Fentanyl.) She was wearing an allergy warning bracelet and the allergy was also noted on her consent forms. In fact Sue had agreed with staff that she would be given Pethidine which is what she had been given after several previous operations and is one of the few drugs that will work for her. When in spite of all of this Sue was given Fentanyl while under sedation, the pain team refused to give her the Pethidine when she came round and refused to call the on-call anaesthetist to change it – they claimed that no one had used Pethidine for years. Even after Sue was able to prove that she had been given it more recently, and prove the agreement to use it on this occasion and her allergy, she was still refused the pain relief that she needed. Faced with this refusal Sue turned to Twitter for help.

Sue Marsh campaigns for disability rights, the NHS and welfare and was the driving force behind the Spartacus Report into the deceitful Personal Independence Payments consultation. On twitter she has six thousand highly politically-connected followers including MPs, journalists from across the political spectrum, political activists and a vast number of sick and disabled people. When she tweeted messages of such obvious distress it created an immediate uproar. Kaliya Franklin (@Bendygirl) quickly made some phone calls and Sonia Poulton came to the rescue. Sonia – a journalist for the Daily Mail – called the hospital and spoke to the Operational Matron who promised to take action immediately. I am pleased to say that Sue was given Pethidine soon after, although as far as I can tell it was not the PCA (Patient Administered Analgesia) which had been agreed on and may have been a relatively small dose.

It is impossible to know at this stage what went wrong here but I hope there will be an investigation into what happened. Certainly Julian Huppert MP has taken an interest and will no doubt ask the right questions. This situation is an extremely serious one. Giving Sue the wrong drug could easily have killed her, and we must ask how often this might have happened to people who are less visible to the public. That decision by itself is bad enough, but the refusal by nurses to correct the mistake is horrendous. Deliberately leaving a patient in pain after major surgery may be considered to be torture.

While the objection to Pethidine PCA would have been a deliberate decision, and the decision to use Fentanyl was perhaps a mistake, it is harder to see how the pain team could justify ignoring Sue’s continuing pain. We can see from earlier tweets that Sue has already experienced similar problems with nurses in her ward:

https://twitter.com/#!/suey2y/status/201404752494469122

https://twitter.com/#!/suey2y/status/201404973056143360

https://twitter.com/#!/suey2y/status/201406727751610370

Please note; I have edited this blog post after talking to Sue about it and I have removed a section which suggested that budget cuts were responsible for what happened. I believe that cuts are harmful to the NHS and will result in serious problems but I have no proof that they were responsible for this situation.

You can read Sue’s tweets from the hospital below, but be warned that they are extremely upsetting.

My electric wheelchair broke a couple of weeks ago after going up a too-steep ramp into a train, toppling backwards and then falling forwards fairly hard. That was quite inconvenient, especially when I discovered that the motors and brakes have burnt out and it will cost about a thousand pounds to fix. Since then I have had to fall back on a manual wheelchair, pushed by my wife. I can move my own wheelchair, just about, but it is still painful and exhausting for me. Fortunately I have just got a new car, so I can drive to most places and then use the wheelchair on arrival. Unfortunately, the manual wheelchair that I was given by family doesn’t fold up enough to fit in the back of my car.

I will qualify for a wheelchair from the NHS, and so I have asked to be referred to the local Wheelchair Services for an assessment. I am slightly stuck though. Walking and standing around result in high levels of pain and fatigue for me, as well as leaving me in danger of losing my balance and falling over. Despite this, I can walk around at home most of the time with only an occasional fall. NHS rules say that I can have a manual wheelchair for use outside, but because I can walk around at home I will not qualify for a powerchair even though I can’t propel myself most of the time. In fact, I probably won’t even get a self-propelled wheelchair since moving it myself can cause some pain and fatigue too, so I will end up with an attendant wheelchair, requiring someone to push me with no option to move myself at all. (See page 16 and 17 of this document for the full rules.)

Because a referral to the wheelchair service will quite likely take a few months, (I won’t be a high priority) and because I will probably get an attendant wheelchair rather than a self-propelled one, I bought a new wheelchair yesterday – a shiny new Karma Wren 2 self propel. The chair cost me £279 from a local shop called Indy Mobility. I could have found it slightly cheaper online but the staff at Indy Mobility were very helpful and put up with me for a couple of hours while I looked at all the options. They also didn’t charge me for the work done so far on my broken powerchair.

My shiny new wheelchair

I was surprised how much easier the new chair is to self-propel than both my old one (and it is old!) and my dad’s one which I borrowed when my power chair broke down. That is partly because the new chair is made from lightweight aluminium but I think also due to it not being worn out. It is light enough that I can lift it into my car myself as long as I am not too tired at the time. It fits nicely in the boot of my car, as you can see in the picture below.

My new wheelchair in the back of my car

Wheelchairs are one of those extra expenses that disabled people can have which Disability Living Allowance is supposed to help pay for. While chairs are available from the NHS, it is quite common for them to be inadequate or to take a long time to get, even apart from cases like mine where I won’t qualify for a power chair which would help me the most. The Motability scheme which leases cars to disabled people in return for the mobility allowance from their DLA can also lease high-end powerchairs to them but I can’t do that because I already spend my DLA on a Motability car so I have had to buy my wheelchair with a credit card at very high interest. I think there are quite a few people stuck in this situation including Kaliya (@BendyGirl) who is currently trying to raise funds for a powerchair of her own. She really needs one to get around outside – just see her “deathwalk” video if you need convincing. Kaliya could use a powerchair inside as well, except that her flat does not have enough room for one. You can donate to Kaliya’s powerchair fund by sending money with Paypal to wheelchairforkali@carolineengland.co.uk or visit her blog post about it.

Karma Traveller 2 powerchair

I have a possibility of getting part of the cost of an powerchair paid for by a local charity – the same one which gave me a small grant when I went to university and gave us food money last year when our benefits were screwed up. They require me to have attempted to get one from the NHS first, and so I must wait until I have been assessed before I can do that. I am hoping to take a voucher towards the cost of a wheelchair rather than a wheelchair itself from the NHS so that I can then put that voucher together with a charity grant if I can get one and buy a powerchair. I plan on getting one that is small and light and can come apart to go in my car – my old one weighed 90kg and even healthy people struggled to lift it. Indy Mobility suggested a Karma Traveller 2 which I think costs about £1,700, although I will have to find out what else is available. For now I will just have to rely on my wife to push me.

Several hundred people gathered today in front of the Ministry of Health to protest against the Health and Social Care bill and what it will do to the NHS. During the course of the protest riot police intimidated and grabbed at protesters, held them against their will, and broke up the protest into small groups that petered out. This was suppression of protest, something that I have written aboutmany times before. As yet the mainstream media outlets have been silent about the protest and about the policing of it. Read on for some images, videos and tweets from the day. For a detailed personal account with many pictures and videos please read This blog post by Cai Wingfield, and see the links at the end of this post for more.

"Outside the department of health!" - photo by @thinktyler"protest in Whitehall" - photo by @COPDdoc

Despite being completely peaceful, the protest received significant police attention within an hour. Large numbers of police vans arrived with Territorial Support Group (TSG – riot police) as well as armed police. The police surrounded the protesters, possibly with the intention of containing (kettling) them – that was certainly how it was perceived. The presence of armed police and being surrounded raised tensions among the protesters significantly.

Let me describe the atmosphere at this point, because in a second things get nasty. COMPLETELY peaceful. The crowd is sparse and moving at a fast walking pace. There is a little chanting but no aggro. The yellow-uniformed police are walking at the same pace of us, and have not (that I’ve heard) requested that we don’t march. The mood is very upbeat. People are smiling and laughing, happy to be doing something positive and perhaps get a little attention (there has been almost no media presence that we’ve seen, unless you count the Socialist Worker as media). The crowd is made up of people of all ages. There are young children and babies, medical students, young adults, up to middle-aged and some elderly people. There is a high proportion of people who have reduced mobility. I spot several people walking with sticks or crutches. I see someone in a wheelchair wearing a V mask, there with their V-masked family.

Now someone shouts something. I’m within a few people of the front of the march. Suddenly, to my right, tens of baseball cap-wearing cops stream out of concealment, running. They’ve obviously been waiting for us.

The mood of the crowd turns quickly to dismay. This is completely out of the blue. These new cops are highly organised and running quickly. They have helmets and truncheons on their belts. People are suddenly scared. There are shouts of “KETTLE! KETTLE!” and “RUN!” from those who see what’s about to happen. People start to run (including me). But it’s too late, they’re already blocking the way ahead of us.

Suddenly it’s clear something is happening. More shouting and running. A line of riot cops is forming ahead, their arms outstretched. Shouts of “KETTLE!” and “RUN!” again from the protesters. We start to run, searching for a break in the line or another way through. All around there is running and screaming, people don’t know what’s happening. I reach the first cops as they start to grab people. I think I see some people grabbed bodily and with serious force, but I don’t stop running. My arm is grasped at by a gloved hand, but I break free. Others are not so lucky, including some of those I’m at the demo with. The line is being held now, people are not being allowed to leave or enter the zone. I see passers by, elderly and disabled people kept inside the cordon. It’s about 4:14pm.

Note that the containment (“kettling”) is fairly loose; it is not the hyper-kettling favoured by the ACPO where crowds are surrounded and compressed and then held for hours as the police and horses closed in. It is people being held without charge and against their will all the same.

It seems that the police still don’t understand that modern protests are arranged through consensus and social media. They persistently try to find the leader, even though there isn’t one. (And then they often use the inability to negotiate with a leader as justification for escalating their tactics.)

Metropolitan Police Territorial Support Group officer U1632 attacked an innocent and totally peaceful protestor, from behind, during a demonstration against NHS privatisation in London, today, 17 March 2012. U1632 ran up behind the young man and whacked him across the calves with a 2-foot long steel-core truncheon, causing his victim to collapse in agony on the pavement, before hauling him off to an unknown fate, out of sight, behind police lines.

I was there today. The van pulled up in front of me and three police got out with what I would identify as a machine gun but not knowing much about these things i@m not sure exactly what type of gun it was.

The protest was not at Parliament Square. It started at the dept. of health where the cenotaph is on whitehall. It moved out onto whitehall where we intended to stay, completely peacefully. A huge number of police started towards us from parliament and we broke and started moving up whitehall towards Trafalgar Square. The police were trying to kettle but the protest was keeping ahead of them. As I got to Trafalgar Square a red police van pulled up as described above.

They only stayed for a few minutes before getting back into the van but it seemed to me like they were trying to intimidate. I still can’t quite believe it. To see this at a peaceful protest in the uk is not in any way normal. I asked a police officer who was stood by the van what the reason for deployment was and he told me to ‘fucking jog on’

Some senior police I spoke to later suggested they were diplomatic police and the van was under threat but I can tell you that they came up, under no threat and made a show of getting out with the guns.

The protest had a very mixed turnout. Many older people there and a lot of disabled people. We weren’t a rabid mob threatening anyone.

It appears that the armed police may have been at the protest by accident, having simply been close by at the time. It should be noted that the armed police were from the Diplomatic Protection Group, a part of the Metropolitan Police that guards diplomatic residencies in London. DPG officers are routinely armed when deployed. Nevertheless, it is not appropriate to send armed police to a peaceful protest and it is not known why they were present.

17:18 Tim Hardy reports on the video that police will arrest remaining people under the public order act for breach of the peace, and that they will be searched. Met police announced that journalists should identify themselves to the police now. @bc_tmh telling the police arresting him that 168 people are watching them live.

http://twitter.com/#!/CO11MetPolice/status/123069745070219264

17:16 Some tweets from @marmite_ about people being held back.
http://twitter.com/#!/marmite_/status/123066828321865729
http://twitter.com/#!/marmite_/status/123067575952351232
http://twitter.com/#!/marmite_/status/123068211242598400

17:12 Message from UK Uncut: “We’ve had questions about the protest. To clarify: The protest is over and UK Uncut is leaving via the SOUTH side of Westminster bridge.”
[blackbirdpie id=”123062828751007744″]

17:07 Met Police have kept back a group of people from leaving, and claimed that they are not associated with UK Uncut. Live stream camera man included. Some brief shouting as police told people to stop filming and some shouts that police were man-handling people with cameras. Keep watching the live stream here. http://bambuser.com/channel/bc_tmh/broadcast/2030568
[blackbirdpie id=”123065725106651136″]

16:56 Reports via live stream that some people are being kettled by the police.

Met police claim some people “not associated with UK Uncut” are attempting to march.
[blackbirdpie id=”123064129966714880″]

16:55 People blocked from leaving from Westminster end.
[blackbirdpie id=”123062774128586752″]

The above video, made by Chelle Denise (@purplegimp on twitter) is heartbreaking. I challenge you to watch it all the way through without crying. She tells us of the realities of living and dying in the US health care system.

A couple of weeks ago there was a debate held by CNN and the Tea Party for Republican party presidential candidates. Ron Paul was asked if a person without health insurance should be left to die if he needed intensive care. He replied “That’s what freedom is all about, taking your own risks. This whole idea that you have to take care of everybody…” That reply received rapturous applause from the audience. The audience were actually applauding the idea of leaving someone to die. (See the video here.)

Chelle desperately needs reconstructive surgery and bone grafts to remove infection caused by Sjorgen’s disease in her jaw and keep her alive. She cannot take the drugs that would treat her lupus and rheumatoid arthritus until having the surgery, as the other drugs would destroy her immune system and allow the bone infection to kill her. And yet, her insurance provider have refused to cover her surgery.

Just think about that. She HAS health insurance, but this company have made a decision to deny her vital surgery to fix something which threatens her life.

In her video Chelle also talked about her friend Jennifer who died recently from cancer. Jennifer was taking an expensive cocktail of medicines to control her pain, paid for by social security disability benefits. When she was admitted to a hospice they did not want to pay for the expensive pain medication upfront even though it would be reimbursed to them and so they switched her from drugs worth $500 a day to methadone which costs merely $8 a time. Methadone (Synthetic heroin) brings with it a range of horrible side effects and it left Jennifer exhausted by causing her to vomit continuously for several days. Even though the methadone was stopped and the previous medications reinstated as soon as the switch was discovered, it was too much for her and she died soon after.

These two stories are a clear example of what happens when healthcare and health insurance are run for profit. Insurance companies don’t care if someone will die because of their choices. All they care about is keeping the costs down and getting out of making payments. They look for loopholes and tiny mistakes just so they can squeeze a bit more profit from their customers. And even when they do pay up, you see choices like that made for Jennifer, where a business operating medical facilities can decide that they don’t like the negative effect on their cash flow of paying for proper medicines that prolong life, even when they would get it back. It’s not just that they are stingy with their money to maximise profits, they won’t even pay to save life now and get the money back later.

Another hearbreaking story in Chelle’s video is that of Steph. (@Steph_in_NC on twitter) Steph is seriously ill with Lupus and Celiac disease. She should not be working, but she does work even though it is hurting her because her family need the income. In theory she could stop work and claim social security benefits but in the US it takes between one and a half and three years to process a permanent disability claim. Steph and her family might be homeless and starving before support is given. I don’t know the reasons for that, but it is indicative of a country where care for each other is horribly absent.

This lack of care and support is obvious when you look at the lengths that Republican politicians have gone to to oppose president Obama’s health care reforms. The idea of everyone contributing to health care insurance and everyone benefiting equally seems to terrify the rich and those who want to be rich. After all, if money can’t buy you some inequality, what is the point of it? I wonder if those Tea Party supporters that applauded the death of those without health insurance would also cheer the death of people who do have cover? I suspect that some are just stupid – supporting the Tea Party as a poor person in the vague hope of becoming a rich person who will benefit from that has to indicate a lack of thinking – but perhaps the richer supporters are happy for those with health insurance to die anyway. It means more money for the shareholders of those health insurance companies.

The ideas of the Republicans and the Tea Party might fit the ideals of Ayn Rand’s objectivism, so influential on US politics in the last few decades, but they are inhuman and cruel. (And also completely out of step with the claims of most supporters of those two groups to be Christians. The bible is pretty big on social justice and caring, but they obviously read a different bible.) The state of health and welfare in the US is shocking and outrageous. Health care and support for sick and disabled people and those without employment is well within the means of the nation as a whole. Instead the wealth, and therefore healthcare, is hoarded by the rich just so that they can feel better than everyone else as they watch the poor die in the street.

This must not be allowed to continue in America, or in any country. This is why I – we – fight so hard in the UK to prevent the Tories from opening up the National Health Service to competition from private companies. This is why we fight to block the government’s efforts to cut the income of sick and disabled people so ruthlessly. For everyone’s sake we must fight this abuse, in the UK, the US, and all over the world.

I have just started taking pregabalin (Brand name: Lyrica) to treat the neuropathic pain that I have been suffering from. When I was discussing it with some friends I discovered something that seemed quite shocking to me. In the USA there are people that need this drug, have been prescribed it by their doctors, but have been deprived of it because their insurance companies have refused to pay for it. This refusal could be because they do not think it appropriate, or do not accept the reality of an illness that is not necessarily detectable in tests, but the most common reason is expense.

It hadn’t actually crossed my mind that pregabalin might be an expensive medicine. My doctor has a nice flowchart of what drugs to try for my illness and what order to try them in, and this one was next on the list. In my blissful ignorance, I simply take the prescription from the doctor to the pharmacy, and walk away with the drugs. All costs covered by the NHS. Since I have long term chronic illness, I am exempt even from paying the £7.20 prescription charge that most people would pay for their drugs.

All of this got me thinking; what if I had to pay for my medicine? Would it even be possible? I currently have twelve medicines on prescription. If I were to pay even the standard prescription charge, with the NHS covering the rest, my medicine bill would come to £86.40 per month. At the moment we are struggling to even pay for our rent, bills and food, so this cost would be crippling. But without the NHS? My drugs would cost much much more. I did some research, and I present here what I would pay for my most important drugs.

That is an astonishing difference between UK and US price.If I had to pay all of it myself, I would have to go without many of my medicines, which would basically leave me unable to control my diabetes and my migraines. Apart from the Lyrica, my pain medication is actually very cheap and I would still be able to afford that. Without diabetes medication I would be practically unable to eat and would still have hyperglycemia. Without sumatriptan, my painkillers would not help and the other symptoms of migraines would keep me firmly in my bed. Fortunately the NHS covers my costs and I have some chance at recovery and leading a relatively normal life. Some people will no doubt argue that it is unfair for me to drain so much money from the NHS. They have failed to understand how this system works. When Aneurin Bevan launched the NHS in 1948 he gave the NHS three aims:

That it meet the needs of everyone

That it be free at the point of delivery

That it be based on clinical need, not ability to pay

Treatment for any given individual may very well be expensive, but it all works out in the end. I have paid National Insurance whenever I have been well enough to work. I receive my medicines without paying when I need them. With those medicines, I may well improve enough to work again and pay more National Insurance. The NHS provides for both people that will one day repay their healthcare costs, and people that might not. Even those that will never be able to work and contribute financially will still contribute something to their society by their very existence. And regardless of future financial contribution, would you really want to live in a world that simply leaves the sick to die?

I am very glad that we have the NHS and I will fight as hard as I can to keep it.The government must not be allowed to ruin what we have.